NP Advanced Physical Health Assessment Syllabus

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1 NP Advanced Physical Health Assessment Syllabus DATE: On Campus Week of July COURSE DESCRIPTION For more information on this course, including the official course description and any prerequisites, can be found in the GPS Catalog at COURSE INTRODUCTION Provides the advanced practice nurse with the tools to perform a comprehensive health assessment on clients across the lifespan. Builds knowledge of anatomy, physiology, pathophysiology and health assessment skills previously attained in undergraduate nurse education. The diagnostic reasoning skills needed for clinical reasoning in the advanced practice role are emphasized. COURSE OBJECTIVES Upon completion of this course, you should be able to do the following: Describe the role of the advanced practice nurse (APN) in comprehensive health assessment as defined by the National Organization of Nurse Practitioner Faculties (NONPF) Domains and Core Competencies. Identify effective and ethical interviewing techniques tailored for various populations, cultural groups, and health conditions. Define the components of a comprehensive health history, incorporating the bio-psychosocial, environmental, cultural, and spiritual factors that enhance or impede an individual s health. Describe the process of gathering and analyzing client data and correlating it with current research data for clinical reasoning. Identify the key anatomical landmarks and features of the human body systems. Demonstrate with 90 percent accuracy the performance of an integrated physical examination for the adult client. Demonstrate beginning skill at differentiating normal, abnormal, and atypical exam findings. Document the findings of a comprehensive health assessment and physical examination of an adult client, integrating assessment findings into recommendations for health improvement.

edu/gpscatalog/ COURSE INTRODUCTION Provides the advanced practice nurse with the tools to perform a comprehensive health assessment on clients across the lifespan.

2 COURSE PREREQUISITE AND/OR MINIMAL TECHNICAL SKILLS Admission into the Master of Science, Family Nurse Practitioner Program at St. Joseph's College. Students should bring a cardiology stethoscope with them to class. REQUIRED TEXT(s) Bickley, L. (2009) Bates' guide to physical examination and history taking (10th ed.). Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins. ISBN: If you have any questions regarding your course materials, please contact your academic advisor and/or our book vendor EdMap. You can reach EdMap by phone 1- (800) or website at COURSE FORMAT Daily classes from 8-4 on campus 7/16-7/20, consisting of lecture, practice sessions, group projects, and group discussions. COURSE GUIDELINES Prior to arriving on campus, the student should have purchased and reviewed the required text, Bickley, L. (2009) Bates' guide to physical examination and history taking (10th ed.). Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins. ISBN: or The CD ROM which comes with the text should be carefully reviewed as well. The following assignments should be completed and brought with you to the first day of class: o Object and Subjective Interactive Exercise (On-Line in Lesson 1.1 of Current 601) o Study Sheet on Assessment (On-Line in Lesson 1.1 of Current 601) CLASS SCHEDULE Class Period 1, July 16th Topic: Overview of the Advanced Health Assessment Process and the Comprehensive Health History

ISBN: 978-0781780582 If you have any questions regarding your course materials, please contact your academic advisor and/or our book vendor EdMap.

3 A. Overview of the purpose and goals of a comprehensive health history B. APN role in comprehensive assessment C. Interview techniques 1. Purposeful data-gathering techniques of subjective and objective data 2. Special populations to include but not limited to elders, children, persons with physical and mental impairments, and persons with diverse cultural backgrounds 3. Ethical considerations in interviewing D. Essential data for a comprehensive health history E, Subjective and objective data F. Documentation (including written/emr) G. Eliciting a comprehensive health history with /class partners REQUIRED READINGS Bickley Text: Chapter 1 Chapter 2, pp Chapter 18, 19, 20 National Organization of Nurse Practitioner Faculties (NONPF). (2006). Domains and Core Competencies of Nurse Practitioner Practice. HYPERLINK " Spain, M.P., et al. (2004). Educating advanced practice nurses for collaborative practice in the multidisciplinary provider team. Journal of the American Academy of Nurse Practitioners, 6 (11) HYPERLINK " 9ba4a1d303ab%40sessionmgr111&bdata=JnNpdGU9ZWhvc3QtbGl2ZQ%3d%3d#db= aph&an= " 9ba4a1d303ab%40sessionmgr111&bdata=JnNpdGU9ZWhvc3QtbGl2ZQ%3d%3d#db= aph&an= In class participation, obtaining comprehensive health history from class partners.

Special populations to include but not limited to elders, children, persons with physical and mental impairments, and persons with diverse cultural backgrounds 3.

4 Class Period 2, July 17th Topic: The Physical Examination A. Sequencing and coordination of a comprehensive physical examination B. Anatomical features and examination techniques by body system Specific advanced exam techniques, practice with partners C. Incorporating abnormals into findings D. Application to the chief complaint (CC) and the history of present illness (HPI) Pertinent positives and negatives Bickley Text: Chapters although an extensive assignment, this is a review of material previously mastered at the undergraduate level. Class Period 3, July 18th Topic: Continuation of The Physical Examination and Differential Diagnosis A. Continued anatomical features and examination techniques by body system Specific advanced exam techniques, practice with partners B. Differential diagnosis (DDx) 1. Application from the ROS, CC, and HPI with rationale 2. Application from the physical exam with rationale 3. Creation of the DDx 4. In class group work - History-Differential Diagnosis Worksheets -Physical Exam-Differential Diagnosis Worksheets -Comprehensive ROS/PE Worksheet Bickley, Chapters 2 and 3, Chapters 4-20 as necessary Class Period 4, July 19th Topic: Physical Exams, Abnormal Findings, SOAP Notes A. Graded evaluation of the Physical Examination, performed with class partners and faculty observation B. Interpreting abnormal physical exam findings 1. In class group work

Application to the chief complaint (CC) and the history of present illness (HPI) Pertinent positives and negatives Bickley Text: Chapters 4-17 - although an extensive assignment, this is a review of

5 ` -Abnormal Finding Worksheet -Interpreting the constellation of symptoms worksheet C. The relationship of abnormal exam findings to potential pathophysiology and clinical history D. Incorporating ROS and PE with documentation 1. In class group work -Comprehensive SOAP-note E. Data-gathering and assessment in difficult situations Bickley Text: Chapters 1, 2, and 3, Chapters 4-20 as necessary Class Period 5, July 20th Topic: Evidence-Based Practice (EBP) and Clinical Decision-Making A. Accessing relevant evidence to guide decision-making and illness investigation 1. In class group work -Diagnostic Probability Worksheet/Plan B. Incorporation of all aspects of assessment 1. Health history 2. Review of systems 3. Illness investigations 4. Physical examination 5. Attainment and evaluation of research evidence Bickley Text: Chapters 1 through 20 as necessary Ebell, M. H. (2006). Point-of-Care Guides. Diagnosis of Migraine Headache. American Family Physician. HYPERLINK " HYPERLINK " Scherokman, B. (1997). Selecting and Interpreting Diagnostic Tests. The Permanente Journal. HYPERLINK " HYPERLINK " Screening and Diagnostic Tests. (2009). emedicine. HYPERLINK

Data-gathering and assessment in difficult situations Bickley Text: Chapters 1, 2, and 3, Chapters 4-20 as necessary Class Period 5, July 20th Topic: Evidence-Based Practice (EBP) and Clinical

6 " HYPERLINK " POST-RESIDENCY ASSIGNMENT (If Applicable) Due Before August 15th: Written documentation of the comprehensive health history, review of systems, and physical examination done in class to be received by above date. Requirements for this written assignment will be reviewed in class. Gale A. Johnsen, PhD Sacopee Valley Health Center P.O. Box 77 Porter, ME Work: e mail: gjohnsen@sjcme.edu COURSE POLICIES AND PROCEDURES Current information regarding College policies affecting your course can be found on the Resources/Policy section of the course homepage. On this page, you will find vital information, including the following: Current Student Handbook, outlining course-specific policies Access to support resources, including advising and online tutorial services Student Success Guides SUBMITTING ASSIGNMENTS Refer to your online classroom for directions on how to submit your assignments. EVALUATION GRADING BREAKDOWN Interactive Subjective and Objective Data Exercise = 2 pts Unit 1 Worksheet =3 pts Documentation of Volunteer Health History = 15 pts

POST-RESIDENCY ASSIGNMENT (If Applicable) Due Before August 15th: Written documentation of the comprehensive health history, review of systems, and physical examination done in class to be received

7 Demonstration of a Complete Head-to-Toe Physical Examination = 25pts Written Documentation of Complete Adult Physical Exam = 10 pts History-Differential Diagnosis Worksheets (2 Cases) = Total 8 pts Physical Exam-Differential Diagnosis Worksheets (2 Cases) = Total 8 pts Comprehensive ROS/Physical Exam Worksheets (2 Cases) = Total 20 pts Abnormal Finding Worksheet = 8 pts History and Physical Exam Abnormalities Worksheet = 5 pts Focused Assessment Documentation = 15 pts Diagnostic Probability Worksheet = 8 pts Assessment/Plan Integration = 8 pts Comprehensive SOAP Note = 15 pts Class Participation Each Session =50 pts Total 200 points A % A % B % B 83-87% B % C % C 73-77% C % F <70% INSTRUCTOR INTRODUCTION Gale Johnsen, PhD, MSN is a family nurse practitioner living in western Maine. She has extensive experience in family practice and geriatrics. She has taught nursing and medical students at both the undergraduate and graduate levels. In addition to her work in education, Gale works at the Sacopee Valley Health Center in rural Porter, Maine, as a Family Nurse Practitioner.

Exam Abnormalities Worksheet = 5 pts Focused Assessment Documentation = 15 pts Diagnostic Probability Worksheet = 8 pts Assessment/Plan Integration = 8 pts Comprehensive SOAP Note = 15 pts Class

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